Serologic Testing for Syphilis: Benefits and Challenges of a Reverse Algorithm

Details

• Personal Author:
  Soreng, Katherine ; Levy, Roma ; Fakile, Yetunde
• Description:
  Syphilis is a human infection of global importance. Its diagnosis can be challenging, requiring construction of a serologic profile based on the results of at least two types of antibody tests: treponemal and nontreponemal. The traditional approach to the serodiagnosis of syphilis has been the use of a nontreponemal screening assay followed by the performance of a treponemal confirmatory test if the initial nontreponemal screening test was reactive. With the increasing availability of automated, easier-to-perform, and rapid treponemal assays, an increasing number of laboratory testing sites are adopting reverse sequence screening for the serodiagnosis of syphilis: screening with a treponemal assay first, then confirmation with a nontreponemal assay and, when necessary, discrepant resolution using another treponemal test. In addition to offering automation and increased throughput, a reverse algorithm can increase disease detection, especially in late latent and early primary stages of infection when the nontreponemal antibody test may be nonreactive. However, a disadvantage to this approach is that there can be an increase in false-positive test results. This article reviews the clinical and workflow benefits and limitations of a reverse testing algorithm and discusses current guidance available from the Centers for Disease Control and Prevention.
• Subjects:
  Article
• Source:
  . 36(24):195-202.
• Pubmed ID:
  28845073
• Pubmed Central ID:
  PMC5568569
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Volume:
  36
• Issue:
  24
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:8e36c371ab4269527ba2578158e420951b8e8ff244fa8a55ff94487d17a4c1bd
• Download URL:
  https://stacks.cdc.gov/view/cdc/48172/cdc_48172_DS1.pdf
• File Type:
  [PDF - 402.37 KB ]